Quantum Sufficit

Just Enough



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Am Fam Physician. 2001 Jan 15;63(2):205-206.

▪ From the “How Do I Get a Job Like That?” file: Folks at the Centers for Disease Control and Prevention are watching daytime television. According to an article published recently in American Medical News, the CDC is giving daytime dramas (soap operas) credit for informing viewers about health issues, health risks and healthy lifestyles. According to a CDC analysis, about 48 percent of daytime viewers report they have learned about a disease or about how to prevent one by watching soap operas.

▪ Did you know that only 35 percent of U.S. health workers get a flu shot every year? This, according to a recent article in Family Practice News, presents a potential health risk not only for the workers but also for their patients. For example, recent randomized controlled studies showed a reduction in nosocomial infections and mortality among elderly patients in chronic care facilities when health care workers at the facilities were vaccinated against influenza.

▪ Speaking of people who don't get flu shots: According to researchers at Johns Hopkins School of Medicine, one group of people in the U.S. typically has fewer screenings for various cancers than other people, are notorious for not getting annual flu shots and are at increased risk of developing health problems over time. The reason for this laxity? They just don't have a regular doctor for preventive health care. Who are these people? Physicians.

▪ Yo-yo dieting: Is it worse than not losing weight at all? According to an article published in the Journal of the American College of Cardiology, researchers from four institutions found that women who repeatedly gain and lose weight (especially if they are obese) have significantly lower levels of HDL than women who maintain their weight. Weight cycling leaves them at increased risk of cardiovascular disease. More research is needed to follow up with the subjects in this study to see if there is a lag time between the drop in HDL level and any direct effect on the development of heart disease.

▪ Picture perfect! A recent issue of Gastroenterology reports on animal studies describing a swallowable capsule that can transmit video images as it travels through the small intestine. According to the study, the fingertip-size capsule moves painlessly through the digestive tract, nudged along by natural contractions, and transmits continuous video images to a recorder applied to the skin. Researchers found that the small video camera was more effective in detecting small bowel lesions than traditional enteroscopy.

▪ People are twice as likely to consult their primary care physician about possible mental health problems than a psychiatrist. A survey by the National Mental Health Association also revealed that a majority of people believe their family physician plays a key role in helping them recover and maintain their mental health. Most patients are comfortable with their primary care physicians and trust them.

▪ Going to Mardi Gras this year? Watch out for flying coconuts! According to an article in the Southern Medical Journal, Mardi Gras parades are unique in that float riders are encouraged to throw as many items from the floats as possible. Objects ranging from plastic beads to coconuts are thrown to eager parade viewers who try to catch them. It's great fun, but it can be hazardous when the item hits an eye. Local ERs report treating many ocular injuries during Mardi Gras, including corneal abrasions, conjunctival hyperemia, subconjunctival hemorrhage and lid lacerations. Coconuts are no longer approved for tossing into the crowd, but you might want to keep an eye out for them anyway!

▪ Perhaps current cold remedies will be replaced by one containing a marijuana-like chemical. Nature reports that anandamide, a naturally occurring neurotransmitter, may control coughing and various respiratory functions. It binds to receptors on muscle cells in the lungs, controlling the lungs' reactions to chemical agents that trigger coughing. The study, involving rats and guinea pigs, will help answer why people respond differently to anti-coughing drugs.

▪ Biologically, we are not all the same on the inside. A study published in Cancer shows that Asian-American cancer patients have stomach tumors with different biologic traits than the tumors found in non-Asians. The study examined 3,770 patients with stomach cancer and found that the survival rate in Asians was much higher than the rate in any other ethnic group. The tumors in Asians do not invade normal tissues as aggressively as tumors in other groups.

▪ Not only do your children need to study before a math test, they also need to consume plenty of iron. Results from a study conducted at the University of Rochester–New York found that iron-deficient children score lower on math tests. Three percent of the children in the study had low iron levels. This percentage rose to 8.7 percent among girls aged 12 to 16.

▪ Mental note: ask potential caregivers in which position they place a child to sleep. A study published in Pediatrics found that infants in child care settings are more likely to be incorrectly placed on their stomachs while sleeping. Infants being cared for by someone other than a parent account for 20 percent of cases of sudden infant death syndrome (SIDS). SIDS deaths are also more likely to occur during the work week between 8 a.m. and 4 p.m.

▪ Didn't your mother ever teach you not to assume? A study published in the Western Journal of Nursing Research shows that the assumption that a woman's mental health improves when she moves from welfare to employment is incorrect. It also found no significant differences on several mental health indicators in women remaining on welfare and those who have gained employment.

▪ Perhaps your patients aren't too lazy to exercise—maybe they're just too bored. In a recent eight-week study conducted at the University of Florida, researchers found that participants who were asked to perform a wider variety of exercises than others in the study (e.g., cardiorespiratory exercises alternating with strength training and flexibility exercises) enjoyed their workouts, exercised longer and were more likely to maintain their exercise program on an ongoing basis than participants who did not perform a variety of exercises.

▪ “On your mark, get set, go!” Researchers at the University of Pittsburgh School of Medicine have uncovered the mechanism by which the brain prepares itself for a task. By conducting a series of functional magnetic resonance imaging studies, they showed that the dorsolateral prefrontal cortex (DLPFC) activates when a person is preparing for a task. Thus, our level of performance might be determined by how activated our DLPFC becomes.

▪ Here's the long and short of it. Family Practice News reports on a study showing that the risk for shoulder dystocia and cesarean section delivery is nearly twice as great in short women (less than 5 ft, 2 in) than in tall women (more than 5 ft, 5 in). This is especially true for short women carrying a large fetus. Tall stature reduced the risk in nulliparous women, but height had no impact on multiparous women, whose risk of C-section is about the same as that of average-height women (5 ft, 2 in to 5 ft, 4 in).



Copyright © 2001 by the American Academy of Family Physicians.
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